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Tips, quips, and pearls| Volume 46, ISSUE 2, P133-138, March 2007

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The Gastrocnemius Intramuscular Aponeurotic Recession: A Simplified Method of Gastrocnemius Recession

  • Author Footnotes
    1 Research Director and Attending Staff, Kaiser North Bay Consortium Residency Program, Department of Orthopedics and Foot & Ankle Surgery, Kaiser Permanente Medical Centers, Santa Rosa, CA.
    Neal M. Blitz
    Correspondence
    Address correspondence to: Neal M. Blitz, DPM, Attending Podiatric Surgeon, Department of Orthopedics, Kaiser Permanente Medical Center, 3925 Old Redwood Highway, Santa Rosa, CA 95043.
    Footnotes
    1 Research Director and Attending Staff, Kaiser North Bay Consortium Residency Program, Department of Orthopedics and Foot & Ankle Surgery, Kaiser Permanente Medical Centers, Santa Rosa, CA.
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  • Author Footnotes
    2 Attending Staff, San Francisco Bay Area Foot and Ankle Residency Program, Department of Orthopedics and Podiatric Surgery, Kaiser Permanente Medical Centers, Walnut Creek, CA.
    Shannon M. Rush
    Footnotes
    2 Attending Staff, San Francisco Bay Area Foot and Ankle Residency Program, Department of Orthopedics and Podiatric Surgery, Kaiser Permanente Medical Centers, Walnut Creek, CA.
    Search for articles by this author
  • Author Footnotes
    1 Research Director and Attending Staff, Kaiser North Bay Consortium Residency Program, Department of Orthopedics and Foot & Ankle Surgery, Kaiser Permanente Medical Centers, Santa Rosa, CA.
    2 Attending Staff, San Francisco Bay Area Foot and Ankle Residency Program, Department of Orthopedics and Podiatric Surgery, Kaiser Permanente Medical Centers, Walnut Creek, CA.
      Gastrocnemius recession is performed as an ancillary procedure in the treatment of a variety of pathologic foot and ankle conditions, most notably symptomatic adolescent and adult pes planovalgus, plantar fasciitis, and diabetic foot pathology (
      • Fulp M.J.
      • McGlamry E.D.
      Gastrocnemius tendon recession Tongue in groove procedure to lengthen gastrocnemius tendon.
      ,
      • Toolan B.C.
      • Sangeorzan B.J.
      • Hansen Jr, S.T.
      Complex reconstruction for the treatment of dorsolateral peritalar subluxation of the foot Early results after distraction arthrodesis of the calcaneocuboid joint in conjunction with stabilization of, and transfer of the flexor digitorum longus tendon to, the midfoot to treat acquired pes planovalgus in adults.
      ,
      • Lin S.S.
      • Lee T.H.
      • Wapner K.L.
      Plantar forefoot ulceration with equinus deformity of the ankle in diabetic patients: the effect of tendo-Achilles lengthening and total contact casting.
      ,
      • Lavery L.A.
      • Armstrong D.G.
      • Boulton A.J.
      Ankle equinus deformity and its relationship to high plantar pressure in a large population with diabetes mellitus.
      ). Several technique modifications have been introduced to potentially decrease complications (especially sural nerve–related problems), anticipate anatomic variation, improve function, decrease postoperative convalescence, and improve cosmesis (
      • Vulpius O.
      • Stoffel A.
      Tenotomie der end schnen der mm. gastrocnemius el soleus mittels mittels rutschenlassens nach vulpius.
      ,
      • Silfverskiöld N.
      Reduction of the uncrossed two-joints muscles of the leg to one-joint muscles in spastic conditions.
      ,
      • Strayer Jr, L.M.
      Recession of the gastrocnemius; an operation to relieve spastic contracture of the calf muscles.
      ,
      • Strayer Jr, L.M.
      Gastrocnemius recession; five-year report of cases.
      ,
      • Baker L.D.
      A rational approach to the surgical needs of the cerebral palsy patient.
      ,
      • Scherb R.
      Die Fensterung der Schnenplatte des Gastrocnemius zur Korrecktur des neuro-myogenen Spitzfußes.
      ,
      • Baumann J.U.
      • Koch H.G.
      Lengthening of the anterior aponeurosis of the gastrocnemius muscle.
      ,
      • Hansen S.T.
      Tendon transfers and muscle balancing techniques.
      ,
      • Pinney S.J.
      • Sangeorzan B.J.
      • Hansen Jr, S.T.
      Surgical anatomy of the gastrocnemius recession (Strayer procedure).
      ,
      • Sgarlato T.E.
      Medial gastrocnemius tenotomy to assist body posture balancing.
      ,
      • Lamm B.M.
      • Paley D.
      • Herzenberg J.E.
      Gastrocnemius soleus recession: a simpler, more limited approach.
      ,
      • Tashjian R.Z.
      • Appel A.J.
      • Banerjee R.
      • DiGiovanni C.W.
      Endoscopic gastrocnemius recession: evaluation in a cadaver model.
      ).
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      References

        • Fulp M.J.
        • McGlamry E.D.
        Gastrocnemius tendon recession.
        J Am Podiatry Assoc. 1974; 64: 163-171
        • Toolan B.C.
        • Sangeorzan B.J.
        • Hansen Jr, S.T.
        Complex reconstruction for the treatment of dorsolateral peritalar subluxation of the foot.
        J Bone Joint Surg. 1999; 81: 1545-1560
        • Lin S.S.
        • Lee T.H.
        • Wapner K.L.
        Plantar forefoot ulceration with equinus deformity of the ankle in diabetic patients: the effect of tendo-Achilles lengthening and total contact casting.
        Orthopedics. 1996; 19: 465-475
        • Lavery L.A.
        • Armstrong D.G.
        • Boulton A.J.
        Ankle equinus deformity and its relationship to high plantar pressure in a large population with diabetes mellitus.
        J Am Podiatr Med Assoc. 2002; 92: 479-482
        • Vulpius O.
        • Stoffel A.
        Tenotomie der end schnen der mm. gastrocnemius el soleus mittels mittels rutschenlassens nach vulpius.
        in: Orthopadische Operationslehre. 1913: 29-31 (Ferdinard Enke, Stuttgart)
        • Silfverskiöld N.
        Reduction of the uncrossed two-joints muscles of the leg to one-joint muscles in spastic conditions.
        Acta Chir Scand. 1924; 56: 315-330
        • Strayer Jr, L.M.
        Recession of the gastrocnemius; an operation to relieve spastic contracture of the calf muscles.
        J Bone Joint Surg. 1950; 32-A: 671-676
        • Strayer Jr, L.M.
        Gastrocnemius recession; five-year report of cases.
        J Bone Joint Surg. 1958; 40-A: 1019-1030
        • Baker L.D.
        A rational approach to the surgical needs of the cerebral palsy patient.
        J Bone Joint Surg. 1956; 38A: 313-323
        • Scherb R.
        Die Fensterung der Schnenplatte des Gastrocnemius zur Korrecktur des neuro-myogenen Spitzfußes.
        Z Orthop Chir. 1935; 63: 335-338
        • Baumann J.U.
        • Koch H.G.
        Lengthening of the anterior aponeurosis of the gastrocnemius muscle.
        Operat Orthop Traumatol. 1989; 1: 254
        • Hansen S.T.
        Tendon transfers and muscle balancing techniques.
        in: Functional Reconstruction of the Foot and Ankle. 2000: 415-417 (Lippncott Williams & Wilkins, PhiladelphiaM)
        • Pinney S.J.
        • Sangeorzan B.J.
        • Hansen Jr, S.T.
        Surgical anatomy of the gastrocnemius recession (Strayer procedure).
        Foot Ankle Int. 2004; 25: 247-250
        • Sgarlato T.E.
        Medial gastrocnemius tenotomy to assist body posture balancing.
        J Foot Ankle Surg. 1998; 37: 546-547
        • Lamm B.M.
        • Paley D.
        • Herzenberg J.E.
        Gastrocnemius soleus recession: a simpler, more limited approach.
        J Am Podiatr Med Assoc. 2005; 95: 18-25
        • Tashjian R.Z.
        • Appel A.J.
        • Banerjee R.
        • DiGiovanni C.W.
        Endoscopic gastrocnemius recession: evaluation in a cadaver model.
        Foot Ankle Int. 2003; 24: 607-613
        • Damron T.A.
        • Greenwald T.A.
        • Breed A.L.
        Chronologic outcome of surgical tendoachilles lengthening and natural history of gastroc-soleus contracture in cerebral palsy.
        Clin Orthop. 1994; : 249-255
        • Banks H.H.
        • Green W.T.
        The correction of equinus deformity in cerebral palsy.
        J Bone Joint Surg. 1958; 40-A: 1359-1379
        • Craig J.J.
        • van Vuren J.
        The importance of gastrocnemius recession in the correction of equinus deformity in cerebral palsy.
        J Bone Joint Surg. 1976; 58: 84-87
        • Banks H.H.
        The management of spastic deformities of the foot and ankle.
        Clin Orthop. 1977; : 70-76
        • Banks H.H.
        Equinus and cerebral palsy—its management.
        Foot Ankle. 1983; 4: 149-159
        • Javors J.R.
        • Klaaren H.E.
        The Vulpius procedure for correction of equinus deformity in cerebral palsy.
        J Pediatr Orthop. 1987; 7: 191-193
        • Olney B.W.
        • Williams P.F.
        • Menelaus M.B.
        Treatment of spastic equinus by aponeurosis lengthening.
        J Pediatr Orthop. 1988; 8: 422-425
        • Takahashi S.
        • Shrestha A.
        The vulpius procedure for correction of equinus deformity in patients with hemiplegia.
        J Bone Joint Surg. 2002; 84: 978-980
        • Smetana V.
        • Schejbalova A.
        The Strayer surgical technic as the basic operation for treatment of pes equinus in cerebral palsy.
        Acta Chir Orthop Traumatol Cech. 1993; 60: 218-224
        • Lamm B.M.
        • Paley D.
        • Herzenberg J.E.
        Gastrocnemius soleus recession: a simpler, more limited approach.
        J Am Podiatr Med Assoc. 2005; 95: 18-25
        • Rush S.M.
        • Ford L.A.
        • Hamilton G.A.
        Morbidity associated with high gastrocnemius recession: retrospective review of 126 cases.
        J Foot Ankle Surg. 2005; 45: 156-160
        • Saxena A.
        • Widtfeldt A.
        Endoscopic gastrocnemius recession: preliminary report on 18 cases.
        J Foot Ankle Surg. 2004; 43: 302-306
        • Downey M.S.
        • Banks A.S.
        Gastrocnemius recession in the treatment of nonspastic ankle equinus.
        J Am Podiatr Med Assoc. 1989; 79: 159-174
        • Sammarco G.J.
        • Bagwe M.R.
        • Sammarco V.J.
        • Magur E.G.
        The effects of unilateral gastrocsoleus recession.
        Foot Ankle Int. 2006; 27: 508-511
        • DiDomenico L.A.
        • Adams H.B.
        • Garchar D.
        Endoscopic gastrocnemius recession for the treatment of gastrocnemius equinus.
        J Am Podiatr Med Assoc. 2005; 95: 410-413
        • Trevino S.
        • Gibbs M.
        • Panchbhavi V.
        Evaluation of results of endoscopic gastrocnemius recession.
        Foot Ankle Int. 2005; 26: 359-364
        • Blitz N.M.
        • Eliot D.J.
        Anatomical aspects of the gastrocnemius aponeurosis and its insertion.
        J Foot Ankle Surg. 2007; 46: 101-108